Evaluation of a real-time hospital surveillance system for respiratory syncytial virus, Ontario, Canada, 2022-2023.

Background: Respiratory syncytial virus (RSV) surged in the 2022-2023 respiratory season after low activity during the pandemic. To monitor the RSV season in real time and support healthcare planning, Ontario introduced daily hospital bed census reporting of RSV hospitalizations by age group (0-17, 18-64, 65 years and older).

Objectives: To assess the completeness and quality of the newly introduced real-time surveillance compared to end-of-season ICD-10 coded hospitalization discharge abstract data (DAD) from November 22, 2022, to March 31, 2023.

Neurological adverse events following COVID-19 vaccination among Canadians referred to the special immunization clinic network.

Neurological adverse events have been reported rarely following COVID-19 vaccination. This study describes the characteristics of adolescents and adults assessed in the Canadian Special Immunization Clinic (SIC) Network for neurological adverse events following immunization (AEFIs) and outcomes of revaccination. Among 60 participants enrolled from January 2021 to February 2023, paresthesia/anesthesia was the most common diagnosis (15/60; 25.

Pediatric Acute Respiratory Virus Hospitalizations: A Population-Based Cohort Study, 2017-2024.

Background: Coronavirus disease 2019 (COVID-19) mitigation measures resulted in widespread disruptions to respiratory viruses. The objective of this study was to compare observed and expected pediatric viral acute respiratory infection (ARI)-related hospitalizations, and the characteristics of admitted children, postpandemic.

Methods: Total and virus-specific ARI-related hospitalization rates were determined using a population-based cohort of youth <18 years in Ontario, Canada between July 2017 and June 2024.

Socioeconomic Inequities in the Age-Specific Burden of Severe Respiratory Syncytial Virus in Canada, 2016-2019.

Background: Limited attention has been given to social inequities in respiratory syncytial virus (RSV), particularly beyond childhood and neighborhood-level measures. This study aimed to quantify the burden of severe RSV disease across the age continuum by individual-level socioeconomic status (SES) indicators.

Methods: We conducted a longitudinal descriptive study of Canadians (excluding Québec) ≥6 months of age using the 2016 Canadian Census Health and Environment Cohort (2016-2019).

Burden of Illness Associated With Respiratory Syncytial Virus, Influenza, and Coronavirus Disease 2019 in Infants and Young Children in Ontario, Canada, 2018-2023: A Population-Based Canadian Immunization Research Network Study.

Background: As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transitions to endemicity and respiratory syncytial virus (RSV) and influenza reestablish their seasonal circulation patterns, understanding their comparative burden on infants and children can guide health system responses and funding priorities.

Methods: This was a population-based cohort study of children aged <5 years in Ontario, Canada, from September 2018 to August 2023 using linked health administrative databases.

Results: Seasonal cohorts comprised 731 838 to 763 660 children.

Neighborhood-Level Burden of Social Risk Factors on Respiratory Syncytial Virus Hospitalization in Ontario, Canada, 2016-2019.

Background: Beyond clinical risk factors, little is known about the impact of social determinants on respiratory syncytial virus (RSV) burden. Our study aimed to estimate RSV-related hospitalization rates across sociodemographic and housing characteristics.

Methods: We conducted a population-based study of all RSV-related hospitalizations in Ontario, Canada, between September 1, 2016, and August 31, 2019, using validated hospital discharge codes and census data.

Revaccination outcomes among adolescents and adults with suspected hypersensitivity reactions following COVID-19 vaccination: A Canadian immunization research network study.

Background: COVID-19 vaccination has been associated with anaphylaxis and hypersensitivity reactions. Infectious disease physicians and allergists in the Canadian Special Immunization Clinic (SIC) Network developed guidance for evaluating patients with adverse events following immunization (AEFI) including suspected hypersensitivity. This study evaluated management and adverse event recurrence following subsequent COVID-19 vaccinations.

The Impact Of Provincial Proof- Of-Vaccination Policies On Age-Specific First-Dose Uptake Of COVID-19 Vaccines In Canada.

Requirements of proof of COVID-19 vaccination were mandated for nonessential businesses and venues by Canada's ten provinces throughout the fall of 2021. Leveraging variations in the timing of these measures across the provinces, we applied event study regression to estimate the impact the announcement of these measures had nationally on age-specific first-dose uptake in the subsequent seven-week period. Proof-of-vaccination mandate announcements were associated with a rapid, significant increase in first-dose uptake, particularly in people younger than age fifty.

School Reopening And COVID-19 In The Community: Evidence From A Natural Experiment In Ontario, Canada.

In December 2020, Ontario, Canada, entered a provincewide shutdown to mitigate COVID-19 transmission. A regionalized approach was taken to reopen schools throughout early 2021 without any other opening of the economy, offering a unique natural experiment to estimate the impact of school reopening on community transmission. Estimated increases of 0.

SARS-CoV-2 Infection Among Maternal-Infant Dyads in Ontario, Canada.

This cohort study uses population-based health data to assess SARS-CoV-2 testing outcomes among infants born in Ontario, Canada, during 9 months of the 2020 COVID-19 pandemic to mothers with confirmed infection at delivery.

Challenges of using asthma admission rates as a measure of primary care quality in children: An international comparison.

Objectives: To demonstrate the challenges of interpreting cross-country comparisons of paediatric asthma hospital admission rates as an indicator of primary care quality.

Methods: We used hospital administrative data from >10 million children aged 6-15 years, resident in Austria, England, Finland, Iceland, Ontario (Canada), Sweden or Victoria (Australia) between 2008 and 2015. Asthma hospital admission and emergency department (ED) attendance rates were compared between countries using Poisson regression models, adjusted for age and sex.

The federal government and Canada's COVID-19 responses: from 'we're ready, we're prepared' to 'fires are burning'.

Canada's experience with the coronavirus disease-2019 (COVID-19) pandemic has been characterized by considerable regional variation, as would be expected in a highly decentralized federation. Yet, the country has been beset by challenges, similar to many of those documented in the severe acute respiratory syndrome outbreak of 2003. Despite a high degree of pandemic preparedness, the relative success with flattening the curve during the first wave of the pandemic was not matched in much of Canada during the second wave.

Family and Child Risk Factors for Early-Life RSV Illness.

Background And Objectives: Most infants hospitalized with respiratory syncytial virus (RSV) do not meet common "high-risk" criteria and are otherwise healthy. The objective of this study was to quantify the risks and relative importance of socioeconomic factors for severe, early-life RSV-related illness. We hypothesized several of these factors, particularly those indicating severe social vulnerability, would have statistically significant associations with increased RSV hospitalization rates and may offer impactful targets for population-based RSV prevention strategies, such as prophylaxis programs.

Palivizumab's real-world effectiveness: a population-based study in Ontario, Canada, 1993-2017.

Objective: To evaluate the effectiveness of two palivizumab programmes targeting high-risk infants, defined by prematurity, diagnosis of comorbidities and geography, and assess potential disparities by neighbourhood income.

Design: Controlled, interrupted time series.

Setting: Ontario, Canada.

Development and validation of a simple algorithm to estimate common gestational age categories using standard administrative birth record data in Ontario, Canada.

Gestational age is often incompletely recorded in administrative records, despite being critical to paediatric and maternal health research. Several algorithms exist to estimate gestational age using administrative databases; however, many have not been validated or use complicated methods that are not readily adaptable. We developed a simple algorithm to estimate common gestational age categories from routine administrative data.

Deprivation and mortality related to pediatric respiratory tract infection: a cohort study in 3 high-income jurisdictions.

Background: Deaths from respiratory tract infections (RTIs) in children are preventable through timely access to public health and medical interventions. We aimed to assess whether socioeconomic disparities in mortality related to pediatric RTI persisted after accounting for health status at birth.

Methods: We compared the prevalence of and risk factors for RTI-related death in singletons aged 28 days to 4 years across Ontario (Canada), Scotland and England (jurisdictions with universal health care) using linked administrative data for 2003-2013.

Community-Based Antibiotic Prescribing Attributable to Respiratory Syncytial Virus and Other Common Respiratory Viruses in Young Children: A Population-Based Time-series Study of Scottish Children.

Background: Inappropriate antibiotic prescribing, such as for viral illness, remains common in primary care. The objective of this study was to estimate the proportion of community-prescribed antibiotics to children aged less than 5 years attributable to common respiratory viruses.

Methods: We fitted time-series negative binomial models to predict weekly antibiotic prescribing rates from positive viral pathogen tests for the period 1 April 2009 through 27 December 2017 using comprehensive, population-based administrative data for all children (<5 years) living in Scotland.

Vancomycin-resistant enterococci (VRE) screening and isolation in the general medicine ward: a cost-effectiveness analysis.

Background: Vancomycin-resistant enterococci (VRE) are a serious antimicrobial resistant threat in the healthcare setting. We assessed the cost-effectiveness of VRE screening and isolation for patients at high-risk for colonisation on a general medicine ward compared to no VRE screening and isolation from the healthcare payer perspective.

Methods: We developed a microsimulation model using local data and VRE literature, to simulate a 20-bed general medicine ward at a tertiary-care hospital with up to 1000 admissions, approximating 1 year.

Assessment of Long-term Follow-up of Randomized Trial Participants by Linkage to Routinely Collected Data: A Scoping Review and Analysis.

Importance: Follow-up of participants in randomized trials may be limited by logistic and financial factors. Some important randomized trials have been extended well beyond their original follow-up period by linkage of individual participant information to routinely collected data held in administrative records and registries.

Objective: To perform a scoping review of randomized clinical trials extended by record linkage to characterize this literature and explore any additional insights into treatment effectiveness provided by long-term follow-up using record linkage.

Risk factors for serious outcomes associated with influenza illness in high- versus low- and middle-income countries: Systematic literature review and meta-analysis.

Aim: To determine factors associated with a serious outcome (hospital admission or severe outcome: critical care or death) and associated with illness caused by laboratory-confirmed influenza, with a specific interest in low- and middle-income countries (LMIC).

Method: Databases were searched on 11 March 2016 for reports of influenza and factors associated with mortality or morbidity in humans, with no language restrictions. Pooled risks were estimated using random-effects models.